Malária cerebral e AIDS: relato de caso

Hinrichsen, S. L.; Moura, L. V.; Ataíde Jr, L.; Travassos, F.; Travassos, P; Albuquerque, E.; Sepúlveda, D. P. L.; Amorim, M. R. G.; Luz, L. M. D. R.; Braga, A. A.; Rocha, L. V.

doi:10.1590/S0004-282X1996000200024

Resumos

Embora não esteja definitivamente comprovada que a severidade da malária esteja associada com o vírus da imunodeficiência humana (HIV), sabe-se que a infecção pelo Plasmodium falciparum pode favorecer uma rápida evolução da infecção pelo HIV. Além disso a associação da malária com HIV/AIDS, do ponto de vista clínico, pode ser extremamente grave face a ocorrência de outros microorganismos e/ou neoplasias, o que piora a evolução e prognóstico dos pacientes. A concomitância do vírus HIV com o Plasmodium em zonas endêmicas de malária, é uma possibilidade que deve ser sempre pensada, visto que a sua transmissão está relacionada a fatores de risco ligados aos comportamentos das pessoas, que nem sempre são logo revelados e/ou identificados. Os autores descrevem um caso de malária cerebral por Plasmodium vivaxe Plasmodiumfalciparum em um paciente com AIDS. Descrevem sua evolução clínica e terapêutica.

malária cerebral; AIDS (SIDA)

Although it has not been definitely proven that the severity of malaria is associated to human immunodeficiency virus (HIV) we know that infection through Plasmodium falciparum can favor a rapid evolution of the HIV infection. Besides, association of malaria with HIV/AIDS from a clinical point of view can be clinically severe in the face of the occurrence of other microorganisms or neoplasias, which worsens the evolution and prognosis of the affected patients. The concurrence of HIV with Plasmodium in malaria endemic zones is a possibility which should always be taken into consideration, since transmission is related to risk factors caused by people's behavior which are not always promptly revealed and/or identified. The authors report one case of brain malaria infection by Plasmodium vivax and Plasmodium falciparum in a patient with AIDS. They describe the clinical evolution and therapy.

cerebral malaria; AIDS

Malária cerebral e AIDS: relato de caso

Cerebral malaria and AIDS: case report

S. L. Hinrichsen^I; L. V. Moura^II; L. Ataíde Jr^III; F. Travassos^IV; P Travassos^IV; E. Albuquerque^V; D. P. L. Sepúlveda^VI; M. R. G. Amorim^VII; L. M. D. R. Luz^VII; A. A. Braga^VII; L. V. Rocha^VII

^IChefe do Serviço de DIP, Coordenadora do NEPA

^IIProfessora Assistente do NEPA/Serviço de DIP

^IIIProfessor Adjunto do Departamento de Neuropsiquiatria/UFPE

^IVLaboratório de Neurodiagnóstico do HC/UFPE

^VServiço de Imagens do Hospital Albert Sabin

^VIResidente do Serviço de DIP

^VIIDoutorandado HC e Estagiária do NEPA/UFPE

RESUMO

Embora não esteja definitivamente comprovada que a severidade da malária esteja associada com o vírus da imunodeficiência humana (HIV), sabe-se que a infecção pelo Plasmodium falciparum pode favorecer uma rápida evolução da infecção pelo HIV. Além disso a associação da malária com HIV/AIDS, do ponto de vista clínico, pode ser extremamente grave face a ocorrência de outros microorganismos e/ou neoplasias, o que piora a evolução e prognóstico dos pacientes. A concomitância do vírus HIV com o Plasmodium em zonas endêmicas de malária, é uma possibilidade que deve ser sempre pensada, visto que a sua transmissão está relacionada a fatores de risco ligados aos comportamentos das pessoas, que nem sempre são logo revelados e/ou identificados. Os autores descrevem um caso de malária cerebral por Plasmodium vivaxe Plasmodiumfalciparum em um paciente com AIDS. Descrevem sua evolução clínica e terapêutica.

Palavras-chave: malária cerebral, AIDS (SIDA).

ABSTRACT

Although it has not been definitely proven that the severity of malaria is associated to human immunodeficiency virus (HIV) we know that infection through Plasmodium falciparum can favor a rapid evolution of the HIV infection. Besides, association of malaria with HIV/AIDS from a clinical point of view can be clinically severe in the face of the occurrence of other microorganisms or neoplasias, which worsens the evolution and prognosis of the affected patients. The concurrence of HIV with Plasmodium in malaria endemic zones is a possibility which should always be taken into consideration, since transmission is related to risk factors caused by people's behavior which are not always promptly revealed and/or identified. The authors report one case of brain malaria infection by Plasmodium vivax and Plasmodium falciparum in a patient with AIDS. They describe the clinical evolution and therapy.

Key words: cerebral malaria, AIDS.

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Full text available only in PDF format.

Aceite: 2-janeiro-1996.

Serviço de Doenças Infecciosas e Parasitárias (DIP) do Hospial das Clínicas (HC)/Núcleo de Ensino, Pesquisa e Assistência em AIDS (NEPA), Univesidade Feeral de Pernambuco (UFPE)

Dra. Sylvia Lemos Hinrichsen - Rua Jerônimo de Albuquerque 188/1803 - 52061-470 - Recife PE - Brasil. FAX 081 268 9905.

Referências bibliográficas

1. Abdool- Karim Q, Abdool- Karim SS, Singh B, Short R, Ngxongo S. Seroprevalence of HIV infection in rural South Africa. AIDS. 1992;6:1535-1539.
2. Allen S, Van-de perre P, Serufilira A, Lepage P, Carael M, de Clercq A, Tice J, Black D, Nsengumerremyi F, Ziegler J. Human immunodeficiency virus and malaria in a representative sample of chiidbearing women in Kigali, Rwanda. J. Infect Dis. 1991; 164: 67-71.
3. Colebunders R, Ryder R, Francis H, Nekwei W, Bahwe Y, Lebughe I, Ndilu M, Vercauteren G, Nseka K, Perriens J. Seroconversion rate, mortality, and clinical manifestations associated with the receipt of human immunodeficiency virus-infected blood transfusion in Kinshasa, Zaire. J Infect Dis 1991:164:450-456.
4. Estambale BB, Knight R. Protozoan Infectious and HIV-1 infection: a review. East Afr Med J 1992:69:373-377.
5. Ferreira MS, Alvorado CA. Malária. In Veronesi R, Focaccia R, Dietze R. (Eds) Doenças infecciosas e parasitárias. Ed 8. Rio de Janeiro: Guanabara Koogan, 1991 ;763-785.
6. Greenberg AE, Nsa W, Ryder RW, Medi M, Nzeza M, Kitadi N, Baangi M, Malanda N, Davachi F, Hassig SE. Plasmodium falciparum malaria and perinatally acquired human immunodeficiency virus type 1 infection in Kinshasa, Zaire: a prospective, longitudinal cohort study of 587 children. N Engl J Med 1991;325:105-109.
7. Harinosuta T, Lassere R, Bunnag D. Trial of mefloquine in vivax and mefloquine plus "Fansidar"in in Falciparum malariae. Lancet. 1985;20: 885.
8. Jackson DJ, Klee EB, Green SD, Nganzi M, Cutting WA. Lymphadenopathy and hepatosplenomegaly in the 1st year in children infected by HIV-1 in Zaire. Ann Trop. Paediatr. 1992;12:165-168.
9. Krogstad DJ. Plasmodium species ( malaria). In Mandell GL, Bennett JE, Dolin R. Principles and practice of infectious diseases. Ed 4. New York: Churchill Livingstone. 1995:2415-2427.
10. Lo SS, Andrade JC, Condino ML, Alves MJ, Semeghini MG, Galvão E. Malaria in intravenous drug users associated with HIV seropositivity. Rev. Saude Public 1991;25:17-22.
11. Martins FSV, Ramos CF Filho, Moreira BM. Quimioterapia da malária I. Ars Cvrandi. I987(6);20:64-78.
12. Martins FSV, Ramos CF Filho, Moreira BM. Quimioterapia da malária II. Ars Cvrandi. 1987(7);20:55-70.
13. Martins FSV, Trade Santos GS, Ramos CF Filho. Malaria. In Schechter M, Marangoni DV. Doenças infecciosas: conduta diagnostica e terapêutica. Rio de Janeiro, Guanabara Koogan. 1994:87-98.
14. Philipis RE, Warrel DA, White NJ. Intravenous quinidine for the treatment of severe Falciparum malariae. N EngU Med 1985;20:1273.
15. Simooya OO, Mwendapole RM, Sikateyo BM. Severe Falciparum malaria and the acquired immunodeficiency syndrome(AIDS in Zambia). Ann. Trop. Med. Parasitol. 1991;85:269-270.
16. Trenholme GM, William RL, Sesjardins RE. Mefloquine (Wrl42,490) in the treatment of human malariae. Science. 1975; 190:792.
17. Warrel DA, Molyneux ME, Beales PF. Severe and complicated malaria. Trans R Soc Med Hyg !990;84(Supp2):l-65.
18. White NG, Lorareesuwan S, Philipis RE, Warrel DS, Chanthavanich P, Pongpaew P. Pathophysiological and prognostic significance of cerebrospinal fluid lactate in cerebral malarie. Lancet. I985;6:776.
19. World Health Organization - World malaria situation in 1990 (Part II). Wkly Epidemiol. 1992;67:169-173.

Datas de Publicação

Publicação nesta coleção
17 Dez 2010
Data do Fascículo
Jun 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Abdool- Karim Q, Abdool- Karim SS, Singh B, Short R, Ngxongo S. Seroprevalence of HIV infection in rural South Africa. AIDS. 1992;6:1535-1539.

[2] 2. Allen S, Van-de perre P, Serufilira A, Lepage P, Carael M, de Clercq A, Tice J, Black D, Nsengumerremyi F, Ziegler J. Human immunodeficiency virus and malaria in a representative sample of chiidbearing women in Kigali, Rwanda. J. Infect Dis. 1991; 164: 67-71.

[3] 3. Colebunders R, Ryder R, Francis H, Nekwei W, Bahwe Y, Lebughe I, Ndilu M, Vercauteren G, Nseka K, Perriens J. Seroconversion rate, mortality, and clinical manifestations associated with the receipt of human immunodeficiency virus-infected blood transfusion in Kinshasa, Zaire. J Infect Dis 1991:164:450-456.

[4] 4. Estambale BB, Knight R. Protozoan Infectious and HIV-1 infection: a review. East Afr Med J 1992:69:373-377.

[5] 5. Ferreira MS, Alvorado CA. Malária. In Veronesi R, Focaccia R, Dietze R. (Eds) Doenças infecciosas e parasitárias. Ed 8. Rio de Janeiro: Guanabara Koogan, 1991 ;763-785.

[6] 6. Greenberg AE, Nsa W, Ryder RW, Medi M, Nzeza M, Kitadi N, Baangi M, Malanda N, Davachi F, Hassig SE. Plasmodium falciparum malaria and perinatally acquired human immunodeficiency virus type 1 infection in Kinshasa, Zaire: a prospective, longitudinal cohort study of 587 children. N Engl J Med 1991;325:105-109.

[7] 7. Harinosuta T, Lassere R, Bunnag D. Trial of mefloquine in vivax and mefloquine plus "Fansidar"in in Falciparum malariae. Lancet. 1985;20: 885.

[8] 8. Jackson DJ, Klee EB, Green SD, Nganzi M, Cutting WA. Lymphadenopathy and hepatosplenomegaly in the 1st year in children infected by HIV-1 in Zaire. Ann Trop. Paediatr. 1992;12:165-168.

[9] 9. Krogstad DJ. Plasmodium species ( malaria). In Mandell GL, Bennett JE, Dolin R. Principles and practice of infectious diseases. Ed 4. New York: Churchill Livingstone. 1995:2415-2427.

[10] 10. Lo SS, Andrade JC, Condino ML, Alves MJ, Semeghini MG, Galvão E. Malaria in intravenous drug users associated with HIV seropositivity. Rev. Saude Public 1991;25:17-22.

[11] 11. Martins FSV, Ramos CF Filho, Moreira BM. Quimioterapia da malária I. Ars Cvrandi. I987(6);20:64-78.

[12] 12. Martins FSV, Ramos CF Filho, Moreira BM. Quimioterapia da malária II. Ars Cvrandi. 1987(7);20:55-70.

[13] 13. Martins FSV, Trade Santos GS, Ramos CF Filho. Malaria. In Schechter M, Marangoni DV. Doenças infecciosas: conduta diagnostica e terapêutica. Rio de Janeiro, Guanabara Koogan. 1994:87-98.

[14] 14. Philipis RE, Warrel DA, White NJ. Intravenous quinidine for the treatment of severe Falciparum malariae. N EngU Med 1985;20:1273.

[15] 15. Simooya OO, Mwendapole RM, Sikateyo BM. Severe Falciparum malaria and the acquired immunodeficiency syndrome(AIDS in Zambia). Ann. Trop. Med. Parasitol. 1991;85:269-270.

[16] 16. Trenholme GM, William RL, Sesjardins RE. Mefloquine (Wrl42,490) in the treatment of human malariae. Science. 1975; 190:792.

[17] 17. Warrel DA, Molyneux ME, Beales PF. Severe and complicated malaria. Trans R Soc Med Hyg !990;84(Supp2):l-65.

[18] 18. White NG, Lorareesuwan S, Philipis RE, Warrel DS, Chanthavanich P, Pongpaew P. Pathophysiological and prognostic significance of cerebrospinal fluid lactate in cerebral malarie. Lancet. I985;6:776.

[19] 19. World Health Organization - World malaria situation in 1990 (Part II). Wkly Epidemiol. 1992;67:169-173.